Do ‘humorous’ references to murder and euthanasia reflect societal beliefs about palliative care?

A recent survey of palliative care doctors published in the Mayo Clinic Proceedings investigates the role that gallows humour plays in the relationships between palliative care physicians and their patients and colleagues.

The online survey, developed by Lewis Cohen MD and colleagues from Tufts University School of Medicine, found that nearly three-quarters of doctors interviewed have been ‘humorously’ accused of promoting death. Most of the comments came from fellow physicians and health care workers.

Parallel to this, results indicated that 25 out of the 633 respondents reported having been formally investigated for hastening a patient’s death. One third of cases were initiated by fellow health care workers.

The study concludes that whether real or in jest, accusations of murder are part of a wider issue. The survey highlights that the presence of gallows humour into the medical environment is representative of conflicting beliefs about end-of-life care, specifically hastening death. The article cites global examples of palliative care cases that have been brought to court, emphasising the international scale of the issue.

Although caring for dying patients is always a serious matter, it would be a mistake to suggest that physicians ought to cease joking about death with their colleagues. Cohen reiterates that, “Levity must remain an acceptable defense mechanism in medicine for coping with the weightiest of medical duties: helping patients to die with grace and dignity”. In Cohen’s opinion, rather than curbing humorous references, it is more important for medical professionals to address the underlying conflicts that exist both globally and within their own community. Accusations from health care professionals clearly indicate that there are strong disagreements over end-of-life care that must be discussed.